C. PROJECT SUMMARY The NMHPVPR monitors the complete continuum of cervical cancer prevention in New Mexico and Is the only population-based, woman-based, cervical screening registry In the U.S. Using clinically relevant electronic medical records (EMR), detailed woman-based information including text dictations is generated for cervical cancer screening, diagnosis and treatment delivered throughout New Mexico. All results of tests whether positive or negative, normal or abnormal are transmitted to the NMHPVPR under state mandate. This unique public health resource serves as the cornerstone of the NM-HOPES-PRC Cervical Cancer Screening Process Documentation Unit. The NMHPVPR information systems, which are fully electronic, transcend organizational structures of healthcare. Reporting to the NMHPVPR is conducted at a national, regional and statewide level and is based at the individual woman and provider levels. By comparison to organizational systems such as Managed Care Organizations (MCO), which suffer both loss from area out-migration and loss to membership due to personal decisions or changes in employer insurance agreements, the NMHPVPR only suffers out-migration from the entire state of New Mexico. New Mexico incurs and average outmigration by comparison to other states, it is 27th In the nation. The NMHPVPR embodies the entire spectrum of clinical practice delivery of cervical cancer prevention Including Indian Health Service Facilities, an MCO, multiple health plans, community-based practice networks and Individual provider practices in largely isolated areas of the state. The annual woman-based data contributions from the NMHOPES from the entire state of New Mexico represent ~225,000 cervical cancer screening Pap events (plus abnormal referral Paps) and an average of over 18,000 diagnostic colposcopy and LEEP treatment visits including clinic visits with cervical, vaginal, vulvar or endometrial biopsy procedures. Beyond the innovations of the NMHPVPR, in anticipation of PROSPR directions and needs, we have engaged specific partnerships with a number of clinic networks who deliver care to the underserved and impoverished Hispanic and American Indian women of our state who are at high risk for invasive cervical cancer. In our selected clinical provider network partnerships, over 30,000 screening Pap tests are delivered each year and over 40,000 individual women screen in a 3-year period versus an estimated 57,000 screen-eligible women. Based on the HEDIS quality measures for cervical cancer (i.e., PAP testing within the measurement year or prior 2 years), our partnering practices deliver cervical cancer screening at varying levels ranging from 68%-72% of their screen-eligible patients. We have specifically partnered with a range of clinical settings to provide broad opportunities to the PROSPR Consortium. Our research projects target gaps in knowledge to enable future interventions to improve cervical cancer prevention.